Medicaid expansion fiscally smart, right thing to do

Yes, that's true about the sequester, too - but we are talking about the risk of Tennessee being left out of the Medicaid expansion.

In just about a month, Gov. Bill Haslam and legislative leaders must let federal officials know whether Tennessee will accept its portion - $5.8 billion - of a federal Medicaid expansion for the Affordable Care Act. The dollar amount is obviously impressive, but even more so is the prospect of adding health coverage for 180,000 Tennesseans who currently have no coverage.

That is approximately the population of Knoxville.

We've known ever since the U.S. Supreme Court's decision last June to uphold most of the Affordable Care Act that a lot of Tennessee politicians would be struggling to embrace the law. When justices struck the part of the law that would require participation in the Medicaid expansion, it gave the politicians a tattered corner of their security blanket to cling to.

It's an interesting public display - the moral center for most Tennesseans turns on whether we can handle the added burden of coverage to new patients. In the Tennessee General Assembly, the test of conscience is whether to betray your anti-Obama credentials. And that is just appalling.

Expansion should be fairly easy to accept, if a legislator looks at the numbers over the long term. Even though the state would be on the hook for 10 percent of the cost of expansion after the first three years, for every $10 that Tennessee spends it will realize a return of $12 from the federal government.

That's the economic appeal. We know that quite a few of our lawmakers don't care about the moral respect of the expansion. We know because of legislation they have proposed in this session and in the last session that is actually designed to take away government benefits for Tennesseans who already struggle to feed families.

It's a shame that these lawmakers' partisan pride is clouding their grasp of finances.

The state hospital association and heads of Tennessee hospitals, who together employ hundreds of thousands of Tennesseans, have tried to reason with lawmakers. These health professionals know that without the Medicaid expansion it is going to become difficult for hospitals, which must absorb indigent patient costs. Smaller, regional hospitals could find it hard to keep doors open at all. Those who do will face staff cuts, a loss of local jobs - and, of course, hospitals and clinics that are understaffed - will find it hard to adequately treat patients.

Refusing the Medicaid expansion is by far the most expensive future scenario for Tennessee ... or, this state could begin to deal with the spiraling cost of health care now.

Republican governors of Michigan, Arizona, North Dakota, Ohio, Nevada, New Mexico and Florida have set aside politics and adopted the Medicaid expansion as the best way forward, financially.

Gov. Haslam and the legislative supermajorities: How about you?

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Medicaid expansion fiscally smart, right thing to do

The clock is ticking. Yes, that?s true about the sequester, too ? but we are talking about the risk of Tennessee being left out of the Medicaid expansion.